Healthcare Provider Details

I. General information

NPI: 1386636439
Provider Name (Legal Business Name): DAVID W. KLEBERGER N.P.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2005
Last Update Date: 12/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 E HARVARD AVE SUITE 530
DENVER CO
80210-7009
US

IV. Provider business mailing address

950 E HARVARD AVE SUITE 530
DENVER CO
80210-7009
US

V. Phone/Fax

Practice location:
  • Phone: 303-765-3484
  • Fax: 303-765-3486
Mailing address:
  • Phone: 303-765-3484
  • Fax: 303-765-3486

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number86336
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number86336
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: